Breastfeeding and allergic disease at age nine in Ireland: An Irish prospective cohort study

Abstract Background Despite well-recognised benefits, Irish breastfeeding rates remain suboptimal. Although associations between breastfeeding and allergic disease are well-researched in younger children, evidence for continued effect in older children is sparse. This Irish prospective cohort study investigated associations between breastfeeding and allergic disease at age nine. Methods The study sample included all nine-year-old children enrolled in the Growing Up in Ireland Infant Cohort Study whose mothers had participated in both Wave 1 and Wave 5. Mothers self-reported infant feeding practices at nine months and allergic diseases at nine years. Multiple logistic regression was used to generate adjusted odds ratios (aOR) for associations between breastfeeding and allergic diseases; re-weighting was applied to enhance generalisability. Results Response rate was 72% (N = 8,006). Most mothers (53%) had ever-breastfed their child; younger mothers, smokers and those of lower socioeconomic status were significantly less likely to have ever-breastfed. Compared to never-breastfeeding, ever-breastfeeding was protective against asthma (aOR 0.74, 95%CI 0.62-0.87) and eczema (aOR 0.72, 95%CI 0.55-0.93) at age nine. Ever-breastfeeding increased the risk of atopic rhinitis (aOR 1.44, 95%CI 1.07-1.94); the association with food allergy was inconclusive (aOR 1.17, 95%CI 0.83-1.64). Breastfeeding ≥6 months was protective against asthma (aOR 0.57, 95%CI 0.39-0.82) and any allergic disease (aOR 0.72, 95%CI 0.55-0.96). Exclusive breastfeeding (3-5 months) was protective against asthma (aOR 0.67, 95%CI 0.50-0.89) and eczema (aOR 0.54, 95%CI 0.34-0.86). Conclusions This study provides new evidence suggesting breastfeeding may be protective against asthma and eczema but may increase the risk of atopic rhinitis in older Irish children. Results must be considered in light of high Irish allergic disease prevalence and action in support of breastfeeding prior to and following birth prioritised accordingly. Key messages Findings lend support to a protective association between breastfeeding and asthma and eczema in later childhood and indicate breastfeeding may play a role in allergic disease prevention. Breastfeeding may reduce the risk of asthma and eczema in Irish children: findings should be used to drive impactful breastfeeding promotion and reorientate cultural norms in favour of breastfeeding.


Background:
Despite well-recognised benefits, Irish breastfeeding rates remain suboptimal. Although associations between breastfeeding and allergic disease are well-researched in younger children, evidence for continued effect in older children is sparse. This Irish prospective cohort study investigated associations between breastfeeding and allergic disease at age nine.

Methods:
The study sample included all nine-year-old children enrolled in the Growing Up in Ireland Infant Cohort Study whose mothers had participated in both Wave 1 and Wave 5. Mothers self-reported infant feeding practices at nine months and allergic diseases at nine years. Multiple logistic regression was used to generate adjusted odds ratios (aOR) for associations between breastfeeding and allergic diseases; re-weighting was applied to enhance generalisability.

Conclusions:
This study provides new evidence suggesting breastfeeding may be protective against asthma and eczema but may increase the risk of atopic rhinitis in older Irish children. Results must be considered in light of high Irish allergic disease prevalence and action in support of breastfeeding prior to and following birth prioritised accordingly.

Key messages:
Findings lend support to a protective association between breastfeeding and asthma and eczema in later childhood and indicate breastfeeding may play a role in allergic disease prevention.
Breastfeeding may reduce the risk of asthma and eczema in Irish children: findings should be used to drive impactful breastfeeding promotion and reorientate cultural norms in favour of breastfeeding.

Background:
The implementation of a health service does not necessarily equate to a health gain. Effective Coverage (EC) aims to capture the potential benefits of a health intervention by adjusting the crude coverage for quality. The aim of this study was to assess the EC of Antenatal Care (ANC), Institutional deliveries and Postnatal Care (PNC) in Oyam district, Uganda, considering the input (drugs and equipment) and the process dimension (components of care provided).

Methods:
The study involved 19 Health Centers (HC), 12 type II, 6 type III and 1 type IV, having a catchment area of 15.603 expected deliveries per year. The analysis covered the period between April and September 2021. Data on crude coverage were retrieved from the District Health Information Software-2. Data used to assess quality domains were extracted from checklists compiled during Supportive Supervisions and were summarized by readiness and likelihood of quality care indices. The crude coverage of the interventions was adjusted to calculate the input-adjusted and the quality-adjusted coverage.

Results:
The readiness index was 0.81 for ANC, 0.82 for institutional delivery and 0.88 for PNC, while the likelihood of quality of care was 0.73, 0.88 and 0.89 respectively. In all three areas, the loss of coverage was mainly due to lack of materials and equipment; HCs II showed lower quality indexes than HCs III, particularly for ANC (P = 0.007). Compared to the target population, EC was 40% for ANC4 visits, 48% for institutional deliveries and 77% for PNC visits. The gap between crude and EC was higher for ANC4 (-30%) compared with the one for institutional deliveries (-18%) and PNC (-23%).

Conclusions:
EC is a useful indicator for monitoring maternal and neonatal services in low-resource countries, bringing gaps in crude coverage to the surface. Supportive Supervision provides an opportunity to assess EC at the facility level without additional resources and to support health authorities in setting priorities. Key messages: The application of EC framework can be adapted both at district and facility level, either to a single service or healthcare pathways, and guide public health intervention. Integration of Supportive Supervision data in the EC is an innovative approach and permit to include the quality of care dimension in the routine data collection. Background: Ultrasound (US) can help monitor normal fetal development and screen for any potential problems. The prenatal detection of fetal anomalies allows for optimal perinatal management. Aim: The aim was to assess congenital anomalies at births and their associated antenatal care factors.
iii412 European Journal of Public Health, Volume 32 Supplement 3, 2022